First Edition: March 11, 2013

Today's headlines include reports about the budget blueprints expected on Capitol Hill this week.

Kaiser Health News: Q&A: I Have A Pre-Existing Condition, Where Can I Get Health Insurance? (Video)
Kaiser Health News consumer columnist Michelle Andrews answers a reader question about insurance options for people with pre-existing conditions (3/11).

Kaiser Health News: Capsules: GOP Senators Seek To Cut Health Law Funding
Now on Kaiser Health News' blog, Mary Agnes Carey reports: "This week, the Senate is expected to consider – and amend -; House-passed legislation that would fund the government through the end of the fiscal year. The bill did not include $949 million in additional funding that the Office of Management and Budget requested for the Centers for Medicare and Medicaid Services, which is overseeing much of the roll-out of the health law. … While the OMB request did not specify what the $949 million would fund, 'it was pretty well known' that the money was to be used to implement the health law's exchanges, said Matt Dennis, a spokesman for Rep. Nita Lowey, D-N.Y., ranking member of the House Appropriations Committee" (Carey, 3/11).

The Wall Street Journal: Opening Budget Bids Set Parties' Battle Lines
Congress opens a new chapter in the budget debate this week with the introduction of dueling blueprints from two lawmakers who illustrate their parties' vastly different approaches to the role of government. … The blueprints, from the parties' budget chiefs, cement how far apart Democrats and Republicans are on tax and spending policy. Mr. Ryan's budget will include no new tax increases or Pentagon cuts while advancing big changes to Medicare and Medicaid, all with the goal of erasing the annual federal deficit in 10 years. Ms. Murray's plan is expected to increase taxes on upper-income households and corporations and make modest spending cuts to domestic programs; it wouldn't balance the budget anytime soon (Hook and Peterson, 3/10).

The New York Times' Political Memo: In Search Of Debt Deal, Obama Walks A Narrow Path
President Obama will go to Capitol Hill this week to try to salvage a big deficit-reduction deal, battling not only Republican resistance but also complaints from Democrats that he mishandled his last attempt. … White House aides have not ruled out some money-saving structural reforms to Medicare that Republicans favor, notably an idea promoted by the House majority leader, Eric Cantor, to combine the program's doctor and hospital components with a single deductible for beneficiaries. Using savings from entitlement shifts like that to replace sequestration, as the automatic cuts are called, would meet Republicans' demands not to use tax increases for that purpose (Stevenson and Harwood, 3/10).

Politico: Democrats Not Sold On A Safety Net Bargain
The talk of any deal with congressional Republicans -; and for now, it's just that: talk -; has liberals worried the White House will give in to changes to safety net programs including Medicare, Medicaid and Social Security (Nocera, 3/10).

The Washington Post: Research Ties Economic Inequality To Gap In Life Expectancy
The tightening economic connection to longevity has profound implications for the simmering debate about trimming the nation's entitlement programs. Citing rising life expectancy, influential voices including the Simpson-Bowles deficit reduction commission, the Business Roundtable and lawmakers on both sides of the aisle have argued that it makes sense to raise the eligibility age for Social Security and Medicare. But raising the eligibility ages -; currently 65 for Medicare and moving toward 67 for full Social Security benefits -; would mean fewer benefits for lower-income workers, who typically die younger than those who make more (Fletcher, 3/10).

The Washington Post: Ryan Calls For Both Obamacare Repeal And Finding 'Common Ground' In Budget Fight
Past House Republican efforts to repeal the president's health-care law failed, and the Supreme Court upheld the constitutionality of the law last year. Ryan's budget proposal, which includes controversial proposals for giving states more authority over Medicaid, is sure to encounter stiff resistance from Democrats in Congress who are committed to protecting Obamacare. That push back is likely to complicate Obama's efforts this week to advance a dialogue he reopened with Republicans last week on reaching a grand bargain on budget cuts and entitlement reform (Brown and Sullivan, 3/10).

Los Angeles Times: Republicans Resume Effort To Repeal 'Obamacare'
Republicans in Congress are renewing their political assault on the nation's new healthcare law, trying to repeal President Obama's signature domestic achievement as part of the next battle over the federal budget (Masacaro, 3/10).

Politico: States Wrestle With New Obamacare Exchanges
Wanted: States to work on Obamacare health insurance exchanges. OK to keep it sort of hush-hush. More than half the states have declared they want nothing to do with setting up or running those health insurance marketplaces opening in their states later this year. But a closer look shows that at least a few of these states, like Ohio and Virginia, may have a larger role than they're letting on (Millman, 3/10).

The Washington Post: Privatizing The Medicaid Expansion: 'Every State Will Be Eying This'
Arkansas has turned heads with its plan to expand Medicaid using the private insurance market. The idea -; which is still preliminary -; would be to use Medicaid dollars to buy private insurance coverage for the expansion population. For health policy experts, this has raised a huge number of questions: Will private plans guarantee the same benefits that Medicaid does? How will states pay for the private insurance, which generally costs more than the public program? And does HHS even have the legal authority to do this? (Kliff, 3/8).

The Washington Post: Arkansas Plan Shows That Health Care Law's Medicaid Expansion Leaves Flexibility For States
The Obama administration has taken a hard line with governors about an option to expand Medicaid under the new health law, telling them to take it or leave it -; but leave it and lose access to millions of federal dollars. It turns out there is some wiggle room after all (Somashkhar, 3/9).

The New York Times: GOP In Arizona Is Pushed To Expand Medicaid
In the battle to get the Medicaid expansion being championed by Gov. Jan Brewer approved by the state's legislators, her closest advisers are hanging their hopes on the number eight. That is how many of the 17 Republicans in the State Senate they believe they can get on their side (Santos, 3/10).

Politico: 'Dental Therapists' Help Deal With Access Gap
Some state lawmakers think they've found the solution to the nation's severe dental care access problem, but so far, only two states are using the touted "dental therapists" -; and dentists aren't thrilled about the idea. According to the Pew Center on the States, more than 40 million Americans reside in areas with a shortage of dentists (Smith, 3/11).

The New York Times: Cuts Give Obama Path To Create Leaner Military
But the next set of cuts will be much harder, because they involve huge constituencies -; in Congressional districts, inside the military services and among veterans' groups. "The problem is that the biggest, most-needed cuts are in programs that also have the broadest set of defenders," said Maren Leed, the director of the defense policy studies group at the Center for Strategic and International Studies in Washington and a former top aide to Gen. Ray Odierno, now the Army's chief of staff. The most obvious examples of those problems come in base closings and higher co-payments or premiums for the beneficiaries of Tricare, the military's sprawling health care program, which costs upward of $51 billion a year (Sanger and Shanker, 3/10).

Politico: Frustrated GOP Health Staffers Jump Ship
If you want to see how frustrated Republicans are with health care, just look at their staffs. Since the election, one top Republican health policy staffer after another has fled the Hill for consulting and lobbying gigs that promise better pay, fewer hours and less obstructionism. ... It's been a bumpy few years for these staffers, most of whom participated in the health care law negotiations in 2009 and 2010, watched as Democrats passed the law without a single Republican's vote, stood by as their bosses continually tried -; and failed -; to ditch the law and saw GOP hopes for entitlement reform fall by the wayside (Cunningham, 3/8).

Los Angeles Times: Democrats, Brown At Odds Over Healthcare Act
As Democratic lawmakers speed to implement President Obama's healthcare overhaul in California, they are finding themselves at odds with the leader of their own party: Gov. Jerry Brown. The governor and legislators disagree over how the state should expand Medicaid to more than 1 million low-income Californians, a critical component of the federal Affordable Care Act (Mishak, 3/9).

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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